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The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction. (Contains 3 tables.)

Describes a new competency-based curriculum and discusses the planning, structure, and implementation of this curriculum at Brown University School of Medicine. (Author/CCM)

A study of 406 Brown University (Rhode Island) medical students found slightly over half had undergraduate majors in science or mathematics, a third majored in the humanities or social sciences, and a tenth had double majors or independent concentrations. No statistically significant difference was found between medical school performances of the first two groups. (MSE)

A study of the performance of Brown University medical students admitted with and without an interview, based on course performance, standardized test scores, and residency evaluations, provides evidence that the selection interview does not contribute to the predictive capacity of the admission process. (Author/MSE)

The fourth-year courses selected by the classes of 1982 and 1986 in the Brown University Program in Medicine were compared. The data support the contention that medical students' perception that residency positions were more difficult to obtain led to changes in selecting courses in the fourth year of medical school. (Author/MLW)

The effectiveness of a cost containment curriculum integrated into a required 6-week community health-primary care clerkship at Brown University is described. A computerized patient management problem was administered to half the students in order to assess its discrete effect on the students. (MLW)

A study compared the performance of 232 Brown University (Rhode Island) medical graduates on senior-year examinations in clinical skills examinations and during residencies, as evaluated by their residency directors. Results indicated a strong correlation between the two evaluations, suggesting that the performance-based undergraduate assessments, which use standardized patients, are good predictors of residency performance. (Author/MSE)

Of 123 matriculants to the Brown University medical program in 1987-88 and 1988-89, more than one-third had taken traditional premedical course requirements after graduating from college. Academic performance, self-reports of preparation, or involvement in extracurricular activities in this group were comparable to that of traditional premedical students in the first two years. (Author/MSE)

The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction. [ABSTRACT FROM AUTHOR]

Assessing medical student competence in non-traditional domains can be challenging. Conventional methods of assessment are generally unsatisfactory. The authors discuss the approach taken at the Brown Medical School, USA to assess students at the beginner, intermediate, and advanced levels in the social and community contexts of health care - one of the nine abilities that comprise Brown's competency-based curriculum. At the beginner level, faculty use weekly field notes written by students about their experiences in community practice placements as the means for assessment. At the intermediate level, faculty assess students based on their completion of a project focused on a community health problem. At the advanced level, a screening process is used in which students first meet individually with a member of the assessment committee who determines if the student's efforts appear to meet the expected standards. If success seemed likely, then the student was encouraged to appear before the whole committee. The authors discuss the common use of subjective judgments at all three levels and the importance of diverse perspectives in achieving a consensus. Allowing students wide latitude in expressing themselves and their accomplishments helps to ensure success. [ABSTRACT FROM AUTHOR]

Part II. Focuses on the development of a competency-based curriculum, known as MD2000. Reasons for developing the curriculum; How it was developed; Details on the curriculum; Significance for medical education.